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Cited by 1,694Obesity, Physical Activity, DietDiabetes, Cardiovascular Risks, and LipoproteinsCancer Risks and Factors

Impact of Overweight on the Risk of Developing Common Chronic Diseases During a 10-Year Period

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Field, Alison E., Coakley, Eugenie H., Must, Aviva, Spadano, Jennifer L., Laird, Nan, Dietz, William H., Rimm, Eric, Colditz, Graham A.·2001·Archives of Internal Medicine
DOI 10.1001/archinte.161.13.1581
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Abstract

BACKGROUND: Overweight adults are at an increased risk of developing numerous chronic diseases. METHODS: Ten-year follow-up (1986-1996) of middle-aged women in the Nurses' Health Study and men in the Health Professionals Follow-up Study to assess the health risks associated with overweight. RESULTS: The risk of developing diabetes, gallstones, hypertension, heart disease, and stroke increased with severity of overweight among both women and men. Compared with their same-sex peers with a body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) between 18.5 and 24.9, those with BMI of 35.0 or more were approximately 20 times more likely to develop diabetes (relative risk [RR], 17.0; 95% confidence interval [CI], 14.2-20.5 for women; RR, 23.4; 95% CI, 19.4-33.2 for men). Women who were overweight but not obese (ie, BMI between 25.0 and 29.9) were also significantly more likely than their leaner peers to develop gallstones (RR, 1.9), hypertension (RR, 1.7), high cholesterol level (RR, 1.1), and heart disease (RR, 1.4). The results were similar in men. CONCLUSIONS: During 10 years of follow-up, the incidence of diabetes, gallstones, hypertension, heart disease, colon cancer, and stroke (men only) increased with degree of overweight in both men and women. Adults who were overweight but not obese (ie, 25.0 < or = BMI < or = 29.9) were at significantly increased risk of developing numerous health conditions. Moreover, the dose-response relationship between BMI and the risk of developing chronic diseases was evident even among adults in the upper half of the healthy weight range (ie, BMI of 22.0-24.9), suggesting that adults should try to maintain a BMI between 18.5 and 21.9 to minimize their risk of disease.

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  • Increases in body weight during 10 years of follow-up were associated with higher risk of hypertension, even within a range of BMIs that were considered normal.

    “In the Nurses’ Health Study and the Health Professionals Follow-up Study, increases in body weight during 10 years of follow-up were associated with higher risk of hypertension, even within a range of BMIs that were considered normal29.”

    From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [29]

  • In NHS I, among a random sample of 200 participants who did not report a previous diabetes diagnosis, only one (0.5%) had elevated fasting plasma glucose or plasma fructosamine in the diabetic range, and her levels were barely above diagnostic cutoffs.

    “Moreover, in another substudy to assess the prevalence of undiagnosed diabetes in NHS I, fasting plasma glucose and plasma fructosamine were measured in a random sample of participants (n = 200) who did not report a previous diagnosis of diabetes. Only one (0.5%) of the women had an elevated fasting plasma glucose or plasma fructosamine level in the diabetic range, and her levels were barely above”

    From Rotating Night Shift Work and Risk of Type 2 Diabetes: Two Prospective Cohort Studies in Women (2011) · cites this paper as [14]

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Authors
Field, A. E., Coakley, E. H., Must, A., Spadano, J. L., Laird, N., Dietz, W. H., Rimm, E., & Colditz, G. A.
Affiliations
  • Brigham and Women's Hospital (US)
  • John Snow (United States) (US)
  • Tufts University (US)
  • Harvard University (US)
  • Centers for Disease Control and Prevention (US)
ORCID
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
2001-07-09
Volume
161
Issue
13
Pages
1581
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.161.13.1581
OpenAlex
W2145279264
Cited by
1,694
References
40
Citations by year
2026: 30 · 2025: 44 · 2024: 51 · 2023: 54 · 2022: 71 · 2021: 53 · 2020: 62 · 2019: 68 · 2018: 61 · 2017: 73 · 2016: 75 · 2015: 78 · 2014: 99 · 2013: 87 · 2012: 101
FWCI
41.66
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
  • National Institutes of Health (46200, DK46200, CA40356, CA55075)
  • National Heart, Lung, and Blood Institute (R01HL035464, HL35464)
  • National Cancer Institute (CA-55075, CA-40356)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200, DK46200.)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Keywords
overweight, obesity, body mass index, chronic disease risk, type 2 diabetes, gallstones, hypertension, heart disease, stroke, colon cancer, hypercholesterolemia, dose-response relationship, middle-aged adults, sex differences
MeSH terms
Cholelithiasis, Chronic Disease, Diabetes Mellitus, Female, Follow-Up Studies, Heart Diseases, Humans, Hypertension, Male, Middle Aged, Obesity, Risk Factors, Body Mass Index, Logistic Models

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